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Healthcare Reform

This category contains 9 posts

Public Health Accreditation

As Keck, Scutchfield, and Holsinger phrase it, “public health is no longer in the position of being the only major health profession without a process to …. accredit its agencies.” But how and why has public health accreditation arisen, and how might it contribute to improving the public’s health? Continue reading


Health: to reform incentives or re-imagine a paradigm?

If any of mainstream economic theory’s assumptions are true, it is that incentives influence behavior (another is that for-profit firms that are legally mandated to maximize profits [see Ebay v. Newmark] will, in fact, maximize profits). If financial incentives under fee-for-service induce physicians to create demand (by prescribing un-valuable services), then realigning these financial incentives … Continue reading

Who gets sick and why?: the lense of Primordial Prevention

Primordial prevention targets the “causes of the causes” of ill-health and harm – the social and political determinants of health. In the US, these political and social environments are characterized by dramatic class-, gender-, and race-based inequalities in health, wealth, representation, agency, safety, rights, and opportunity. Continue reading

Is the US Healthcare System “health care” or a “system”?

To use the word “system” to describe healthcare in the United States is to imply intentionality, coordination, and comprehensiveness, none of which can be appropriately applied here. Continue reading

Social Justice is the Smart Health Investment

Addressing the social determinants of health and well-being directly at the policy level may be both the most cost-effective and moral path forward. Though inequalities in power and wealth have been central to the critiques of western capitalist societies since the earliest days of the industrial revolution, and though industrial activity’s specific harms to human … Continue reading

Medicare’s Assessment of Brigham and Women’s Performance

Boston’s Brigham and Women’s Hospital (75 Francis Street; a subsidiary of Brigham and Women’s Healthcare) is a major teaching hospital of Harvard Medical School and among the best regarded acute care referral centers in the United States 1. In 1980, three separate hospitals were merged to constitute the present center 2. As of its 2012 … Continue reading

The 21st Century Physician

The economic and political realities that will define medicine’s practice environment in the United States during the coming decades are difficult to predict. But the competencies and qualities that will define the successful physician are much clearer. 21st century physicians must be habitual life-long learners to stay abreast of translational breakthroughs and technological innovations. They … Continue reading

Medicine’s Professional Organization

The medical profession is organized as a rigidly delineated, legally mandated, and culturally reinforced pyramidal hierarchy within the larger hierarchical health services system. Advancement in the medical hierarchy is achieved in a number of ways. Pre-medical students just beginning their training must combine high academic achievement with competitive scoring on the standardized Medical College Admissions … Continue reading

New Thinking: Medical Hot Spots

Atul Gawande, associate professor of surgery and public health at Harvard and one of our most prolific contemporary physician-writers, adapts his New Yorker piece surveying innovative attempts to lower healthcare costs by better serving those patients with greatest need to a 13 minute PBS FRONTLINE report focused on one such program, the Camden Coalition of … Continue reading